What do I need to know about feeding my baby during the first year of his or her life?
Nutrition during the first year of your baby’s life is important for proper growth and development. Babies are also developing oral and motor skills. It is necessary to feed your infant based on his or her feeding skills and developmental age. Here are some suggestions to help you feed your baby.
How often should I feed my baby?
Babies know when they are hungry or full. Feed your baby every time he or she is hungry. Breast-fed infants should breastfeed 8-12 times a day, approximately 10-15 minutes per breast at each feed. Formula-fed infants should be fed 6-10 times a day, including overnight. Adding foods to a bottle such as rice cereal to make the baby sleep at night is not appropriate, as it can cause excessive weight gain and decrease important nutrient intake, and may be a choking hazard.
As your baby starts eating solid foods, he or she will drink less. Slowly increase the amount of solid food you offer and decrease the amount of breast milk or formula. Remember, all foods should be offered by spoon and not in the bottle.
How do I know when my baby is hungry or full?
Babies can cry or be fussy because they are hungry, tired, upset, uncomfortable, or need a diaper change or to be burped. Some general signs that your baby is hungry include the following:
- Smacking lips
- Grabbing for or leaning toward breast or bottle
- Pointing at spoon, food, or feeder’s hand
- Moving hands to mouth and sucking his or her own hands
When hunger cues are missed, babies tend to get upset, with fussing or crying. It is important to try to catch hunger cues to make feedings more enjoyable for both the baby and the caregiver.
Some signs that your baby has had enough to eat include:
- Pulling away from bottle, spoon, or breast
- Falling asleep
- Changing position, shaking head, keeping mouth closed tightly, moving hands actively
- Handing food back to the feeder
How do I know when my baby is ready for solid food?
The American Academy of Pediatrics and the World Health Organization recommend exclusively breastfeeding for the first six months of the baby's life; however, if not exclusively breastfeeding, some babies may be ready to start solid foods between four and six months of life.
Every baby develops differently, so here are signs to look for to know your baby is developmentally ready for solid food:
- Baby can sit upright with little or no support in the high chair.
- Baby has good head control for long periods of time.
- Baby is hungry for more nutrition after 8 to 10 breastfeedings or 32 ounces of formula.
- Baby shows interest in what you are eating.
- Baby readily opens mouth to accept the spoon feeding.
For children with special needs, speak with your child’s physician or therapists about seating/adaptive feeding. Please speak with your physician and/or dietitian if your baby was born early.
Guidelines for feeding your baby:
- Start with a spoonful or less of each food. Increase the food gradually to 1-2 spoonsful, advancing slowly over several days. The goal for feeding is 1 small jar (4 ounces or a cup) of strained baby food per meal.
- Always introduce one new “single-ingredient” food at a time. Wait 3-5 days before introducing another new food to assess for possible allergic reactions, such as diarrhea, vomiting, or a rash. If any reaction occurs, stop feeding the new food and call your pediatrician.
- There is no evidence on which single-ingredient food to start with. Many people start with infant cereal. If breastfeeding, consider starting with a vegetable, then advance to meat to provide nutrients that are lower in breast milk.
- If making your own baby food, it is recommended to use pureed peas, pureed corn, and sweet potatoes. Do not add salt, sugar, or other flavorings. It is recommended to avoid homemade spinach, beets, green beans, squash, and carrots, since they contain nitrates, which can cause anemia (low blood count). However, commercially prepared versions have been tested for nitrate content. Fresh foods spoil faster than commercially prepackaged baby food.
- Meats and vegetables contain more nutrients per serving than fruits or cereals.
- Four ounces of 100% pasteurized fruit juice can be started in a sippy cup once the baby turns 7 months old, with no more than 4 ounces of juice per day. Fruit juice offers no benefit over eating a piece of fruit.
- When your baby can bring his or her hands and objects to the mouth (typically around 9-12 months), you can slowly decrease mashed/baby foods and offer more finger foods. A child will typically self-feed from 9 to 12 months, and will not use a fork or spoon typically until after 12 months of age. Cut food into small pieces to prevent choking.
- Limit meal time to 15-20 minutes and reduce distractions such as watching TV.
- Most infants should eat 3-6 times a day (3 meals and 2-3 snacks).
- Good foods for your baby include foods rich in energy, protein, vitamins, and minerals, such as meat/poultry/fish and colorful fruits and vegetables.
- Foods to avoid:
- Spicy, salty, and sugary foods
- Foods that may cause choking, like: nuts, seeds, popcorn; chips, pretzels; raw fruits and vegetables, such as carrots and apples; raisins, whole grapes; hot dog pieces; sticky foods, such as a spoonful of peanut butter or marshmallow
- Do not give your baby honey.
- Don't warm baby's bottle or food in the microwave, as it can burn the baby's throat or mouth. Instead, warm bottles in a pan of warm water or under a stream of warm tap water. Shake the bottle after warming to be sure the milk or food is heated evenly.
- Always feed your baby in an upright position with a spoon. For children with special needs, speak with your child’s physician or therapists about seating/adaptive feeding.
- Don't let your baby fall asleep with a bottle. The milk collects in the baby's mouth and may cause tooth decay and choking, and can lead to ear infections.
- You should not give your baby solid foods in a bottle. This may cause choking or overeating, and it may slow your baby's development of feeding skills.
- The foods (dairy products, eggs, soy, wheat, fish, shellfish, peanuts, and tree nuts) previously thought to cause food allergies if started too early are now recommended when starting soft chopped table foods. If feeding peanut butter, provide a small thin amount on bread, not a spoonful at a time. Talk to your doctor if you have questions or concerns.
- Be patient when offering new foods, as it may take 10-15 times to increase acceptance.
Typical Portion Sizes and Daily Intake for Infant’s Age
- Breast milk or infant formula (2-4 ounces); Feedings per day: 8-12
- Breast milk or infant formula (6-8 ounces); Feedings per day: 4-6
- Infant cereal (1-2 tablespoons)
- Breast milk or infant formula (6-8 ounces); Feedings per day: 3-5
- Infant cereal (2-4 tablespoons)
- Crackers (2); bread (1/2 slice)
- Juice or water (0-3 ounces)
- Fruit or vegetable (2-3 tablespoons)
- Meat or beans (1-2 tablespoons)
- Breast milk or infant formula (6-8 ounces); Feedings per day: 3-4
- Cheese (1/2 ounce) or yogurt (1/2 cup)
- Infant cereal (2-4 tablespoons); bread (1/2 slice); crackers (2); or pasta (3-4 tablespoons)
- Juice or water (3 ounces)
- Fruit or vegetable (3-4 tablespoons)
- Meat or beans (3-4 tablespoons)
While babies do not need additional water or juice for hydration, it is recommended to provide some in a cup to help with transition off the bottle, which is recommended at 12 months. For any additional questions, set up an appointment with a registered dietitian.